Bug Chasers: Gay Men and the Intentional Pursuit of HIV - A Narrative Analysis

Imagine you are sitting down with a dear friend that you haven’t seen in years because he ran away from an unloving, unsupportive home, from a town where he was different, picked on, and knew he could never be safe - at least that is how he felt, - to a place where he would find love, and the supportive family he so dearly wanted. He discloses that he is gay and living with HIV infection. He says not to worry, that it’s ok, and then he says, “There’s more.” You feel your heart beat faster and time suspends. You imagine he is going to say he’s dying, but instead he speaks about HIV as a “gift” and you think you are hearing things. After what seems like an eternity, you say something like, “did I hear you say you got infected with HIV on purpose?” And the resounding but fuzzy answer is “yes, I got infected with HIV on purpose – they call me a bug chaser.“

Trying to contract HIV - the bug - on purpose is a phenomenon that received considerable attention following the release of a critically acclaimed and controversial documentary, The Gift(Hogarth, 2003), that chronicles the real story of Doug Hitzel who did just that. After repeatedly watching it, I decided to conduct a study founded on my own confusion. My resounding questions -- can it be that men intentionally want to become HIV positive? Are there really other men out there like Doug with stories of seeking HIV on purpose?

It took less than 3 months for participants to answer my recruitment flyers -- they were eager to share their stories and I took pride in providing the platform. I worked with 18 wonderful men who, for several reasons, sought to contract the HIV virus on purpose. The age range for participants spanned several decades, from the youngest participant at age 33 years to the two oldest participants at age 61 years. Most (n=6) were between ages 46 and 50 years. The average age of the sample (N=18) was 48 years. Most of the 18 participants were self-identified as African American (n=15). One participant who identified himself as “other” was of mixed race (i.e., Italian and African American), one was Latino, and one was Caucasian. A majority of participants (n=10) lived below the HHS poverty level for a one-person household ($11,170). Here are a few of their stories (pseudonyms were chosen for each participant).

When you have discordant love, the desire for harmonious love is immense. Meet Sennet who describes a conversation with his HIV infected lover:

“And I said, ‘So?’ Then he said, ‘Are you alright with this?’ Then I said, ‘I love you! I don’t care! If I get it, I get it…you want to give it to me? You think I am going to leave? You think I am going bail on you? No, I’m not.’ And that was how it started.”

Meet Desiderius who was first raped by his older brother when he was only six, and then for many years later while he was incarcerated. He says; “And finally the rapes stopped.” His decision to seek HIV infection was easy – HIV positive men in prison are tarnished; “they won’t rape me anymore.” The Latin translation of Desiderius is “so long hoped for, craved and desired.” It is how I chose to describe this participant.

For some gay men religion can cause much confusion and influence drastic actions. Karan (Sanskrit for warrior), told a sad story about being barred from his church:

“The church that I was a member of threw me out when they found that I was gay. I am not unique… there are a lot of people like me; they might not go as far as I did, but I’m not unique. Having HIV is not the worst thing that could have happened… it brought me to a better place spiritually.”

Getting HIV would mean he would die for his sin – drawing analogies to God "dying for our sins.” Karan was sure contracting HIV would make him “holy.”

And then there’s Thornton (old English for “in from the thorns”). Messages from Catholic high school about homosexuality might have set the foundation for his addictions, both sex and drugs. He described the foundation of these challenges: “I am angry and disappointed, I did everything that I could to change my sexual identification.” He is still troubled by his past and the turmoil that led to the acceptance of his sexual identity. He describes himself as having, “just little bit of self-hatred, and anger with God.” Thornton denied any regrets for contracting HIV. As long as his HIV infection does not cause him to end up in diapers, he says he will not worry. Guilt drives much of his thinking. Thornton makes connections to his life now, and those of young gay boys addicted to the party scene, who are also addicted to sex. In admitting his intentional HIV pursuit, Thornton also claims, “Nowadays, I deserve this if anybody does, not just a 19-year-old kid.”

Understanding bug chasing requires understanding life beyond the mainstream and suspending judgment. The decision to deliberately seek HIV infection cannot fully be explained by conventional or rational choice modeling. Even though the bug-chaser/gift-giver relationship does not promote physical health, healthcare providers cannot ignore their professional duty to treat these men with compassion and understanding. The reasons for their intention, behavior, and search for identity remain fundamentally misunderstood (Dean, 2009). To the bug chaser, securing HIV may be a rite of passage into a fraternal community from which one can never be exiled (Dean, 2008). It is impossible to share all of what I learned through my research, but the highlights are resounding; men do indeed seek to contract HIV infection as the answer for many of life’s challenges. There is still so much more to learn, and my doctoral research was an attempt to understand. For all of the men, a sense of belonging was inherent to being HIV positive. I discovered that their wish to be HIV positive completely vanquished their wish to remain HIV negative. The desire for love, to belong, to fit in, no matter the peripheral influences, only skim the surface of how deeply influential societal views are for gay men. Conflicted societal beliefs, stigma, and a host of other reasons changed these men. The problem was not HIV; rather, the greater problem was navigating HIV and navigating society as a gay man. I have come to believe that seeking HIV was simply a prolonged, disguised reaction to wanting what all human’s want- to be loved and accepted, at least in these cases.

The “gift” as described by Doug Hitzel in the documentary, “pulls you in because it seems like the biggest box. In a whole room of presents, it’s got the best bow, it’s got the best ribbon, and it looks like the biggest and the funnest [sic], and you open it up and it’s like a big ball of nothing and it just sucks all the life from you.” At the end of the documentary Doug shares, “I just can’t believe that it seemed like a livable thing to me—there was no benefit in this [bug chasing]—and that’s just what really needs to be said.”

Keep in Touch

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U1OHA28686 (AIDS Education and Training Centers National Coordinating Resource Center) awarded to the François-Xavier Bagnoud Center, Rutgers University School of Nursing. No percentage of this project was financed with non-governmental sources. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government.